Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
DOB
-
Month
-
Day
Year
Date
Highest Level of Education
Please Select
GED
High School Diploma
Associates
Bachelors
Masters Degree
Pure Barre Experience
Yes
No
If so, how many classes?
Are you able to attend a 4 day training?
Yes
No
Availability (Click all that apply)
early morning
mornings
afternoons
evenings
weekends
On a scale of 1-10, how do you feel about being on the mic?
On a scale of 1-10, how comfortable are you being hands on in a classroom setting?
Do you have dance or class instructor background?
How would you describe your personality in one sentence?
What do you love the most about Pure Barre?
Submit
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